Question: Does the 2 percent sequestration cut apply to claims with dates of service on/after April 1, 2013, or does it apply to claims submitted on/after April 1, 2013?
Distinguish ‘rigid’ and ‘flexible’ scopes.
You’ll need to “rewrite” your esophagoscopy reporting beginning Jan 1, 2014 because CPT® entirely rewrites the codes in that section of the CPT® manual.
With 12 new codes, two deleted codes, and 14 revised codes in the range 43191-43232, you have a lot to learn by the first of the year. Read on to make sure you’re ready with our expert tips.
Differentiate Codes By Scope Type
Different locations, same physician? Use established patient codes.
When reporting many common E/M services, you must ask yourself two questions: First, is the patient new or established? And second, what are the documented levels of history, physical exam, and medical decision-making (MDM)? We’ve got some quick tips on how to use this information to select the correct E/M level every time.
3 Year Rule Determines Patient Status
Know your rights when submitting claims to Medicare patients brought in by law enforcement personnel
CMS recently released clarifying language on Medicare claims for patients in the custody of law enforcement. While this is presumably intended to just be a clarification of existing CMS policy, the description of “prisoner” seems quite broad. With the exclusions of those actually “imprisoned” in a long term corrections facility; the remainders of these patients typically get their more serious care in the ED. The resulting paradox for ED providers remains the combination of an EMTALA mandate to screen for emergency medical conditions and at least stabilize or transfer the patient and a federal regulation prohibiting payment for those same services.
Pre-eclampsia is a condition where hypertension occurs during a patient’s pregnancy along with significant amounts of protein in the urine. This is the most common dangerous pregnancy complication, and it may affect both the mother and the unborn child.
Currently, you should report this condition with these ICD-9-CM codes:
- 642.40, Mild or unspecified pre-eclampsia as to episode of care
- 642.41, Mild or unspecified pre-eclampsia with delivery
- 642.42, Mild or unspecified pre-eclampsia with delivery with postpartum complication
- 642.43, Mild or unspecified pre-eclampsia antepartum
- 642.44, Mild or unspecified pre-eclampsia postpartum
Question: Which diagnosis code should we report for a patient who comes in for a routine hip replacement follow-up that includes an x-ray?
See what this practice did right, and what it did wrong.
If you see a patient who has multiple problems, it can be easy to underestimate the amount of documentation that you actually produce. But that can lead you to undercoding your claims in some cases. Check out the following pediatric note submitted to Pediatric Coding Alert and see if you can spot where the coding went wrong.
Checking for CPT® updates just in January puts pathology coders at risk. The latest CPT® Assistant helps prevent these compliance snafus by spelling out which code updates to watch for and where to find them. This feature article takes the mystery out of molecular pathology coding by explaining the codes’ intent, describing included and separately reportable services, listing CPT®-specific definitions, and offering a helpful handful of FAQs to resolve commonly faced issues.
But, of course, the just released September issue doesn’t limit itself to just one topic. Whether you’re expanding your knowledge or need to research a specific claim, find what you need by typing a code or keyword from the list below into SuperCoder.com’s Code Connect:
- Care plan oversight: 99339, 99340, 99374, 99375, 99377-99380
- Molecular pathology: 81201-81203, 81228, 81229, 81235, 81252-81254, 81264, 81321-81326, 81342, 81400-81408, 81479, 87149, 87150, 87152, 87153, 87470, 87801, 87900, 87901-87904, 88271-88275, 88365, 88367, 88368, 88380, 88381
- Wireless capsule endoscopy: 91110-91112, 91117.
Results from Poll dated September 8, 2010
The results are in on Coders’ Roles – and most of you provide coding. You’re also busy with compliance responsibilities and some of you do education and auditing.
If your lab monitors immunosuppressant drug levels for patients undergoing a procedure, such as kidney transplant, that results in rejection you’ll have many more specific code options when ICD-10 goes active on Oct. 1, 2014.
Currently, you would report a kidney transplant rejection as 996.81 (Complications of transplanted kidney).
But under ICD-10, you’ll have five codes to choose from when reporting complications of a kidney transplant, as follows:
- T86.10 — Unspecified complication of kidney transplant
- T86.11 — Kidney transplant rejection
- T86.12 — Kidney transplant failure
- T86.13 — Kidney transplant infection
- T86.19 — Other complication of kidney transplant.